Orbital melanoma.

Primary or secondary orbital melanomas are extremely rare tumors; they represent less than 1% of primary orbital neoplasms. Over 90% of primary orbital melanomas arise from melanocytes (congenital ocular melanosis, oculodermal melanosis). In the Department of Ophthalmology, Comenius University, Bratislava, in period 2001-2007, a total number of 79 patients with uveal melanoma (dg. C69) were treated with radical surgery, combined techniques or isolated stereotactic radiosurgery, 45 (57%) patients with ciliary body and choroidal melanomas were treated with primary enucleation, 34 (43%) patients were managed with combined techniques (parsplana vitrectomy with endoresection, brachytherapy plus stereotactic radiosurgery) or with "conservative treatment", namely with stereotactic radiosurgery alone. In group of melanoma patients, primary orbital melanoma was present only in 1 case (1 %) (Fig. 4, Ref. 5).

[Posterior capsule opacification in long-term follow-up of patients after implantation of hydrophilic/hydrophobic intraocular lens Acri.Smart]. / Opacifikácia zadného puzdra pri dlhodobom sledovaní pacientov po implantácii hydrofilnej/hydrofóbnej sosovky Acri.Smart.

AIM: The aim of the retrospective study was to establish the frequency of the posterior lens capsule opacification after the cataract surgery and artificial intraocular lens (IOL) Acri.Smart 46S (Acri.Tech Zeiss) implantation. MATERIAL AND METHODS: The study group consisted of 72 eyes (30 men and 28 women), their average age was 65.4 +/- 8.4 years, with performed cataract surgery and implanted IOL Acri.Smart 46S (Acri.Tech Zeiss). After the average period of 32.4 +/- 7.3 months after the surgery, the patients underwent the examination with refractive error measurement, uncorrected and best-corrected visual acuity for for, and posterior lens capsule transparency examination with dilated pupils and with retroillumination photography taken by NIDEK EAS-100 device. RESULTS: After the average follow-up period of 32.4 +/- 7.3 months after the surgery, the refractive error was -0.32 +/- 0.8 diopters and average cylindrical error -0.8 +/- 0.6 Dcyl. The uncorrected visual acuity (UCVA) was 0.72 +/- 0.3, and the best-corrected visual acuity (BCVA) 0.95 +/- 0.2. The average diameter of the examined posterior capsule was 5.89 +/- 2.1 mm, and the transparency of the posterior capsule was 98.41 +/- 8.5%. In two eyes (2.7%) only, the YAG capsulotomy was performed. CONCLUSION: The IOL Acri.Smart is safe, easy to implant IOL, which meets the requirements of the microincision surgery. The IOL had very low incidence of posterior lens capsule opacification, and in two eyes (2.7%) only the YAG capsulotomy was performed.

[Arteriovenous decompression for branch retinal vein occlusion with internal membrane peeling for macular edema]. / Artériovenózna dekompresia pri parciálnej oklúzii centrálnej vény sietnice so zlúpnutím vnútornej membrány sietnice pre edém makuly.

PURPOSE: A retrospective study of anatomical and functional results of microsurgical therapy of branch retinal vein occlusion with internal limiting membrane peeling due to macular edema. MATERIALS AND METHODS: Eleven patients (5 men and 6 women), mean age 59.18 years (34-74 years) who underwent the surgery at the Department of Ophthalmology, Comenius University in Bratislava, Slovak Republic, from June 1st, 2000 to May 31st, 2006, were enrolled in the study. The follow-up period ranged from 14 to 72 months (average 28.5 months). The patients were indicated to the arterio-venous decompression with internal retinal membrane peeling due to the macular edema after the fluorescein angiography. Patients with rubeosis of the iris were excluded from further evaluation and their initial best corrected visual acuity was 0.3 and less. A complete eye examination (best corrected visual acuity, intraocular pressure, fluorescein angiography, slit lamp examination of both the anterior and posterior eye segments) was performed in each patient before the surgery, and every 3-4 months during the first year and every 6-9 months during following years. Fluorescein angiography was used to evaluate anatomic results 3 months after the surgery. As positive signs were considered: the blood flow improvement peripherally to the arteriovenous decompression site, the vessel dilatation, and the reduction of the hyperfluorescence and the macular edema reduction. To analyze the functional results, the best corrected visual acuity changes before and after surgery were used. RESULTS: Positive anatomic changes were in 8 (72,73%) patients; in 1 patient the area of non-perfusion expanded, and 2 patients were presented with stable anatomic findings. The best corrected visual acuity averaged 0.16 (+/- 0.1070) before the surgery, 0.2909 (+/- 0.2264) 3 months after the surgery, and 0.3818 (+/- 0.3178) at the time of the last examination. Significant differences between the visual acuity before and 3 months after surgery were confirmed by Student's T-test. The visual acuity measured at the time of the last measurement improved by +2 and more lines in 6 patients, reminded unchanged in 4 patients, and worsened by -2 or more lines in 1 patient. CONCLUSION: Microsurgical treatment of branch retinal vein occlusion expands the therapeutic armamentarium used to manage this severe disease. In case the partial occlusion is present, arteriovenous decompression has a positive effect on the final anatomic and functional results.

[Posterior capsule opacification following the implantation of various types of IOLs--part II. Different intraoperative findings]. / Opacifikácia zadného puzdra sosovky po implantácii rôznych typov umelých vnútroocných sosoviek-- II. cast: rôzne peroperacné nálezy.

PURPOSE: The posterior capsule opacification (PCO) is the most frequent complication of uncomplicated extracapsular cataract extraction (ECCE). It is caused by incompletely removed epithelial cells of the original lens capsule, which proliferate and migrate along the internal anterior and posterior surface of capsule. Clinically, the PCO manifests as blurred vision and decrease of visual acuity. Opacification of the initially transparent posterior capsule occurs in patients who underwent the ECCE at variable time after surgery. According to the currently published results, the incidence of PCO varies from 10 to 40%, 3 to 5 years after the cataract surgery. In patients with certain types of IOLs (sharp-edged IOLs), the PCO rate has been reported as low as 5%. The anterior eye segment analyzing system is a device designed to measure the degree of PCO objectively and thus to compare the various types of IOLs, various surgical techniques and their effect on the PCO development, independently on the patient's visual acuity. The aim of the study proposed is to assess PCO development in patients operated on at the Department of Ophthalmology of Faculty Hospital Bratislava, Slovakia, EU, by means of the EAS 1000 machine (NIDEK). MATERIALS AND METHODS: The aim of this prospective study was to evaluate the PCO development following the implantation of various IOLs types based on the measurement of the eyes of patients operated on at our department. PCO assessment was performed by EAS 1000 on day 1, day 7, and 3, 6, 12, 24, and 36 months after the cataract surgery. Capsules of patients with various intraoperative findings were compared in the study. The first (and largest) group consisted of patients with no postoperative fibrosis and no perioperative complications (I. part). The second and third groups included patients with the intraoperative findings of posterior capsule fibrosis and patients with previous eye surgery, respectively. RESULTS: No significant drop of posterior capsule transparency was detected following the implantation of various types of intraocular lenses. In the group of eyes compromised by previous surgery, the comparison was possible to be made on the first postoperative day only, yet with an insignificant result. CONCLUSION: Anterior eye segment analyzer EAS 1000 (NIDEK) allows objective evaluation of posterior lens capsule transparency using the digital retro-illumination photography. It appears that not all posterior capsule findings in eyes with intraocular lenses are suitable for such objective analysis.

[Posterior capsule opacification (PCO) following implantation of various types of IOLs--part one: the uncomplicated course]. / Opacifikácia zadného puzdra sosovky po implantácii rôznych typov umelých vnútroocných sosoviek--I. cast: nekomplikovaný priebeh.

PURPOSE: Despite of decreasing incidence of the PCO, this is still a major and frequent complication of cataract surgery and IOL implantation. Therefore, in our Department, we pay currently intense attention to the PCO problem. The introduction of EAS 1000 in October 2001 allowed us to analyze exactly the relevant PCO issues and our attitude toward its treatment as well. The purpose of our study was to compare the PCO degree in eyes with implanted either PMMA IOLs with round edges or hydrophilic acrylate IOLs with sharp edges. Four types of IOLs were compared in our trial. MATERIALS AND METHODS: In the Department of Ophthalmology, Comenius University and Faculty Hospital, Bratislava, Slovakia, the PCO development was analyzed in patients operated on due to senile cataract between November 14th 2001 and April 10th 2003. Eighty-two eyes of 77 patients were followed-up from November 2001 till April 2006. During the 36 months' follow-up, 82 eyes of 77 patients were enrolled in this study. We evaluated the PCO at day 1, week 1 and 3, 6, 12, 24, and 36 months after the cataract surgery. In all patients, the best visual acuity was assessed. The photographs of the posterior capsule in retro-illumination in the widest possible mydriasis were obtained and evaluated by means of EAS 1000. RESULTS: Our study revealed significant influence of the optic material and the type of the implant edge on the PCO development. We did not find any correlation between the visual acuity and the transparency of the posterior capsule. The incidence of Nd:YAG-laser capsulotomies was similar in the two compared IOL groups (PMMA round edged vs. hydrophilic acrylate sharp edged IOLs). We also did not find any correlation between the size of area evaluated and the posterior capsule transparency. CONCLUSION: In our experience, EAS 1000 (NIDEK) has proved to be a suitable device for the follow up of the PCO development following various IOLs types implantation in both experimental and clinical setting. Standardized and objective evaluation systems based bn the retro-illumination photography are needed. Despite a certain possibility of examiner-related error of measurement, EAS 1000 (NIDEK) is an accurate device for PCO evaluation.